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This is VAERS ID 592428

Case Details

VAERS ID: 592428 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2015-07-27
Onset:2015-08-03
   Days after vaccination:7
Submitted: 2015-09-01
   Days after onset:29
Entered: 2015-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 1 UN / SYR

Administered by: Other       Purchased by: Other
Symptoms: Colitis ulcerative, Haematochezia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal ulceration (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: PHEH2015US016860

Write-up: Case number PHEH2015US016860, is an initial spontaneous report from a physician received on 25 Aug 2015. This report refers to a patient of unknown demographics. Historical conditions were not reported. No concomitant medication was reported. The patient was vaccinated with first dose of BEXSERO (batch number: not reported) on 27 Jul 2015. On 03 Aug 2015, the patient experienced ulcerative colitis and bloody stools. Final outcome, seriousness and causality were not reported. Seriousness of the event colitis ulcerative was upgraded based on Novartis Important Medical Events list.


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